{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T17:17:55Z","timestamp":1769620675157,"version":"3.49.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Insulin resistance increases the risk for gestational diabetes mellitus (GDM) and hyperglycemia-associated pregnancy complications. GDM is generally diagnosed at 24\u201328 weeks of gestation, leaving limited time to address adverse consequences. To explore metabolic markers that predict changes in insulin sensitivity and glycemic responses earlier in pregnancy, we performed a meal tolerance test (MTT) during the early and late second trimester in an at-risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 30 pregnant women with overweight or obesity in the Pregnancy Outcomes and Maternal Insulin Sensitivity (PROMIS) study. Glucose, insulin, and C-peptide levels were measured in fasted and post-challenge blood samples between week 12-16 (MTT1, n=26), week 24-25 (MTT2, n=21), and by an oral glucose tolerance test in week 26-27 (OGTT, n=19) of gestation. Pearson\u2019s correlation test, Spearman\u2019s correlation test, and linear regression were applied to evaluate the association between parameters at early and late time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fasting insulin and C-peptide at MTT1 were associated with insulin resistance measured by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) later in pregnancy (r=0.752, p&amp;lt;0.001; and r=0.825, p&amp;lt;0.001, respectively). Post-challenge increase in glucose, insulin, and C-peptide following MTT1 correlated with HOMA-IR in the late second trimester (r=0.626, p=0.009; r=0.739, p=0.002, and r=0.579, p=0.024, respectively). HOMA-IR and Matsuda index at MTT1 correlated with late second trimester HOMA-IR (r=0.781, p&amp;lt;0.001; and r=-0.826, p&amp;lt;0.001 respectively). Sixty, 90, and 120 minutes- post-challenge glucose during MTT2 correlated with 2 h-glucose during the OGTT (r=0.633, p=0.009; r=0.782, p&amp;lt;0.001, and r=0.639, p=0.008).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In the early second trimester, fasting insulin and C-peptide might be suitable to stratify women early for GDM risk. The correlation between the MTT and OGTT results supports further exploration of the MTT as a patient-friendly alternative for diagnostic purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/clinicaltrials.gov\/study\/NCT04315545<\/jats:ext-link>\n                      , identifier NCT04315545.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1763137","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:22:54Z","timestamp":1769577774000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early pregnancy meal tolerance test responses and their association with later insulin sensitivity in overweight and obese women: an exploratory analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Puspito","family":"Arum","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University Medical Center Groningen, University of Groningen","place":["Groningen, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anoush","family":"Kdekian","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Medical Center Groningen, University of Groningen","place":["Groningen, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen L.","family":"Lutgers","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, University of Groningen","place":["Groningen, Netherlands"]},{"name":"Medical Centre Leeuwarden","place":["Leeuwarden, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanne J.","family":"Gordijn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen","place":["Groningen, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maaike K.","family":"Veenstra","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, University of Groningen","place":["Groningen, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maaike","family":"Sietzema","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, University of Groningen","place":["Groningen, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine K.","family":"Kruit","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Medical Center Groningen, University of Groningen","place":["Groningen, 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